Emily Bourke, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7692 Issued in OK

Practice address

1801 Parkview Dr
El Reno, OK 73036-2103

Phone

(405) 295-1500

NPI assigned

May 19, 2023

Last updated

May 19, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinton Indian Health Center

  • Federal Public Health Clinic/Center
  • Clinton, OK
  • NPI 1205923448

  TX

  Medicare reassignment NPD
• El Reno Indian Health Center

  • Public Health or Welfare Agency
  • El Reno, OK
  • NPI 1386725604

  TX

  Medicare reassignment NPD
• Watonga Indian Health Center

  • Public Health or Welfare Agency
  • Watonga, OK
  • NPI 1558458794

  TX

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1003507914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 JORDAN AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730134740",
            "telephone_number": "405-315-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PARKVIEW DR",
            "city": "EL RENO",
            "state": "OK",
            "postal_code": "730362103",
            "telephone_number": "405-295-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURKE",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "7692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Birdsong
• Zachary Blackowl
• Dawn Lee Bland, M.S. CFY-SLP
• Tyrani Nashelle Blaylock - Thomas
• Victoria Blazevich
• Tanya Boyd
• Bradley Bibb MD PLLC
• Tracie Lynn Brady, FSP
• Brian R. Shafer DDS, P.C.
• Wylie Dean Briggs II, D.C.

• Dentist in El Reno, OK
• Providers in El Reno, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.